The non-debate on FGC

by zunguzungu

There’s something just a bit off about calling Female Circumcision or Female Genital Mutilation a “controversial topic.” After all, everyone is against it, right? Or, rather, everyone whose opinion counts. If you’re “for” it, in any sense, you’re hardly someone who can be reasoned with, hardly someone whose opinion matters. All reasonable people agree, etc.

For example, take a look at the “debate” that erupted when the American Academy of Pediatrics rewrote their policy on female genital mutilation. This was the response from Equality Now, a press release immediately parroted, point by point, by Katy Kelleher at Jezebel and PZ at Pharyngula, and seconded by Andrew Sullivan:

International human rights organization Equality Now is stunned by a new policy statement issued by the American Academy of Pediatrics (AAP), which essentially promotes female genital mutilation (FGM) and advocates for “federal and state laws [to] enable pediatricians to reach out to families by offering a ‘ritual nick’,” such as pricking or minor incisions of girls’ clitorises. The Policy Statement “Ritual Genital Cutting of Female Minors“, issued by the AAP on April 26, 2010, is a significant set-back to the Academy’s own prior statements on the issue of FGM and is antithetical to decades of noteworthy advancement across Africa and around the world in combating this human rights violation against women and girls.

Among other things, the AAP now use the phrase “female genital cutting” or “ritual genital cutting” instead of “female genital mutilation,” the term preferred by advocacy groups like Equality Now. In the words of the AAP:

…”mutilation” is an inflammatory term that tends to foreclose communication and that fails to respect the experience of the many women who have had their genitals altered and who do not perceive themselves as “mutilated.” It is paradoxical to recommend “culturally sensitive counseling” while using culturally insensitive language. “Female genital cutting” is a neutral, descriptive term.

Pharyngula calls this a “bizarre bit of pandering” and voices the doctors in question thusly “We’ll just mutilate baby girls a little bit, to make the misogynist patriarchal assholes happy.” Melissa McEwen at Shakesville adopts the same sarcasm soaked rhetoric: “Girls get only a little heinous physical and psychological trauma, and their guardians get to practice their violent misogyny, just in a slightly less violent way. Yay for compromise!”

Now, on the issue itself, I don’t particularly disagree with Andrew Sullivan’s statement that “forcing this onto infants, male and female, even if it is just a cut or a nick, is a form of barbarism” (though I find the word “barbarism” pretty unhelpful), nor do I think McEwen is wrong to say that “There is no reason to tolerate even this proposed alternative version of the procedure in a culture with an ostensible belief in gender equality.” If you frame it as a “would you allow your daughter” problem, my reaction is going to be the same as theirs. Of course not.

But it’s not your daughter, is it? And all the super-heated rhetoric on this issue, all the delightfully gratifying sarcasm launched at straw-misogynists whose arguments and beliefs you are thereby enabled to never actually know about helpfully snarks out of existence the incredibly thorny problem that the AAP is trying to find the least bad solution to, the problem of juggling culturally specific notions of rights and justice, and the rights people have to choose what is best for their children, with the belief by liberal minded people that their notions of justice are right.

Now, again, on the issue of FGC, I pretty much agree with all of the people I’ve just linked to. My views on this issue are pretty conventional liberal morality; I believe in gender equality and I find this practice to be some fucked up repugnant shit. But the problem that the AAP are taking seriously doesn’t stop being a problem just because you’re right and they’re wrong. It’s an even more difficult problem, especially then, because the important question of how and where one intervenes, at what point you start forcing people to adopt your moral compass, is never a simple one. And by the way, I do believe there might be a point where you start using the power at your disposal to force less powerful people to share your values. I may even think so in this case; again, cutting babies is pretty close to what I would be willing to entertain as a universal Thou Shalt Not.

But here’s the thing, white people: when it comes to forcing non-white people to act in ways that you decide are civilized, you better tread light as fuck, and proceed with some caution and humility. There is nothing obvious about the right answer, in that situation; there is, in fact, only a choice between bad solutions, on of which you might, perhaps, decide is the least bad of the two.

It’s striking to me, therefore, that most of the red-hot rhetoricians opining on the issue seem to have little or no awareness of what the AAP actually wrote, or why; it seems telling that the Jezebel piece didn’t even link to the AAP report, just the press release hyperbolically denouncing it (until, of course, a thoughtful comment thread pointed out how poorly she had mischaracterized their position). In fact, while and Pharyngula declared that “[t]heir whole policy is designed to avoid confronting misogynistic bigots with the horrendous consequences of their traditions,” the AAP framed the issue as a problem of how to educate immigrant communities not to perform FGC, which they repeatedly and graphically warn is dangerous at best and of no medical value. Their (very tentative) argument is simply that compromise and education might be able achieve what criminalization will fail to do:

Some physicians, including pediatricians who work closely withimmigrant populations in which FGC is the norm, have voicedconcern about the adverse effects of criminalization of thepractice on educational efforts. These physicians emphasizethe significance of a ceremonial ritual in the initiation ofthe girl or adolescent as a community member and advocate onlypricking or incising the clitoral skin as sufficient to satisfycultural requirements. This is no more of an alteration thanear piercing. A legitimate concern is that parents who are deniedthe cooperation of a physician will send their girls back totheir home country for a much more severe and dangerous procedureor use the services of a non–medically trained personin North America. In some countries in which FGC is common,some progress toward eradication or amelioration has been madeby substituting ritual “nicks” for more severe forms.

Unlike the angry writers I first linked to, the AAP has footnotes and (limited) data that they see as supporting their position. But, more importantly, there are two points that none of the writers I linked to seem cognizant of:

1. This is all academic. As the AAP puts it, “The option of offeringa “ritual nick” is currently precluded by US federal law, whichmakes criminal any nonmedical procedure performed on the genitalsof a female minor.” And since the AAP is completely clear that this “ritual nick” is not a medical procedure (and is illegal anyway), what they’re actually advocating for is simply opening the door to rendering some form of compromise legal. As they put it:

…offering such a compromise may build trust between hospitalsand immigrant communities, save some girls from undergoing disfiguringand life-threatening procedures in their native countries, andplay a role in the eventual eradication of FGC. It might bemore effective if federal and state laws enabled pediatriciansto reach out to families by offering a ritual nick as a possiblecompromise to avoid greater harm.

But the take-home message is that FGC is, currently, always illegal; the last line of the “education” section is that “Parents should be reminded that performing FGCis illegal and constitutes child abuse in the United States.” There are no death panels in this bill, people.

2. Parents actually have rights to make important decisions about their children, and the fact that they have a different cultural sense of what is best than you doesn’t change that. The AAP decision is incomprehensible except from the standpoint of that problem, which is, I think, why none of the bloggers seem to understand it (though I suspect they also haven‘t read it very carefully). This would be an important place to start:

The American Academy of Pediatrics policy statement on newbornmale circumcision expresses respect for parental decision-makingand acknowledges the legitimacy of including cultural, religious,and ethnic traditions when making the choice of whether to surgicallyalter a male infant’s genitals. Of course, parental decision-makingis not without limits, and pediatricians must always resistdecisions that are likely to cause harm to children. Most formsof FGC are decidedly harmful, and pediatricians should declineto perform them, even in the absence of any legal constraints.However, the ritual nick suggested by some pediatricians isnot physically harmful and is much less extensive than routinenewborn male genital cutting.

Now Sullivan’s position is against both male and female circumcision, full stop, which is a consistent position for a political advocate to hold. But the AAP has to find a consistent position from a different perspective, that of medical practitioners. And their point is that, right now, doctors are performing male circumcisions whose illegality is not in question, and which are much more “extensive” than the ritual nick they’re advocating. In other words, if you accept that male circumcision is not harmful (as legal and medical practice do), then they argue that the “ritual nick” (but not all the other forms of FGC) can’t be seen as harmful either. And since, as they put it, “Efforts should be made to use all available educational andcounseling resources to dissuade parents from seeking a ritualgenital procedure for their daughter,” they are opening the door to using the “ritual nick” as a way of doing so.

Now, I have real questions about the entire “ritual nick” idea. I don’t think that it will work, in short, because I doubt that a doctor-performed “ritual nick” will ever fill the function that the various “traditional” demands for it prescribe. But that’s a slightly different issue. For now, the point I want to underscore is that all the commentary I’ve read on this issue hyperbolically simplifies the issue in ways that enable their own moral posturing at the cost of moving farther and farther from the real issues at stake. The AAP represent doctors trying to serve patients, so they’re obliged to deal with the profoundly difficult shades of grey that this problem represents. The various pundits who rail against the very idea of thinking about compromise are not; they have, in fact, a direct interest in ignoring all those shades of grey, because it makes it more difficult to make their own position seem obvious and righteous.

After all, those doctors need to respect their patients for all sorts of reasons, but above all — as the flow of their logic demonstrates — they need access to these populations if they are to do any good at all. And exactly how far do you think they would get if, as Pharyngula demands, they spent all their time “confronting misogynistic bigots with the horrendous consequences of their traditions”? How many mothers will die in childbirth because they didn’t get medical attention because they knew physicians would not allow them to do what they wanted with their children, for example? I don’t know the answer to that question, but neither does anyone. And the AAP have the advantage in this debate of at least realizing it’s a debate. Calling people “misogynistic bigots,” on the other hand, betrays your complete lack of interest in why people would actually do this sort of thing. High on your moralistic high horse, you don’t care. And by painting lurid pictures of “misogynist patriarchal assholes…waving scalpels about in the genitals of children,” you can pretend that it’s an open and shut case, that no reasonable people would ever, all without even knowing what peoples reasons are.

At least as important is the fact that doctors are not all-powerful fiat wielding enforcers of liberal ethics. The rhetoric of “should we tolerate” presumes that they are, that deciding what the principle will magically translate into practice. Kelleher’s assertion that “no type of female genital cutting should be tolerated no matter the degree” is a nice abstract statement of principles. But the entire AAP statement is based on the fact that doctors are faced with the public health issue of immigrant populations to whom they have little access and over whom they have little power. As a member of the AAP’s bioethics committee, Dr. Lainie Friedman Ross, pointed out, for example:

“If we just told parents, ‘No, this is wrong,’ our concern is they may take their daughters back to their home countries, where the procedure may be more extensive cutting and may even be done without anesthesia, with unsterilized knives or even glass,” she said. “A just-say-no policy may end up alienating these families, who are going to then find an alternative that will do more harm than good.”

In the rhetorical world of “should we tolerate,” the question can be yes or no. But doctors live in the real world, where “no” is an option they may not have the power to put into practice. And who do you think has a better sense of that reality, Dr. Lainie Friedman Ross or a bunch of fire-breathing bloggers who haven’t bothered to understand her argument (much less address it)? It’s the AAP, after all, that actually have data backing up their assertion that “in some countries where FGC is common, some progress toward eradication or amelioration has been made by substituting ritual ‘nicks’ for more severe forms.”

* * *

Now, my sense of FGC is that it’s overwhelmingly practiced on adolescent girls, not on infants. And so, this entire discussion has very little to do with the most common versions of the practice. Moreover, I don’t think most of the bloggers who have opined on this issue have thought particularly hard about the difference; because they’re trying to be as hyperbolic as possible, they tend to emphasize an image of FGC in which powerful men are cutting helpless females, for which infant FGC is the most powerfully polemic site. But compare that to Fuambai Ahmadu’s description of what female circumcision is like in Sierra Leone, where she is from:

…the institution itself is synonymous with women’s power, their political, economic, reproductive and ritual spheres of influence. Excision, or removal of the external clitoral glans and labia minora, in initiation is a symbolic representation of matriarchal power. How can this be so? Removal of the external glans and hood is said to activate women’s ‘penis’ within the vagina (the clitoral ‘shaft’ and ‘g-spot’ that are subcutaneous). During vaginal intercourse, women say they dominate the male procrea­tive tool (penis) and substance (semen) for sexual pleasure and reproductive purpose, but in ritual they claim to pos­sess the phallus autonomously. Excision also symbolizes the ‘separation’ of mother and son or of matriarchy and patriarchy (in Mande mythology matriarchy is portrayed as prior to and giving birth to patriarchy). Female elders say that initiation and the act of excision is a potent emo­tional and psychological reminder to men that it is women who give birth to them and mothers who, after God, are the natural origins or raw elements from which all human creation, culture and society are derived. This concept of a primordial, supreme and all-powerful Mother is at the core of Mande creation mythology and ritual practices that are prevalent even today.

This has been a very long post, and I need to stop. But if you’d read this far and are actually interested in this issue, the thing to do now is read Fuambai Ahmadu.If you think you know anything about this “debate,” and yet you’ve read only pundits and advocates who speak in hyperbole and polemic about the barbaric practices of non-white people, and yet you’ve not read or heard from a single woman of color who underwent some variant of the practice and can explain why she doesn‘t regret it, then you are not taking the question seriously. And there is no better way than casual unexamined racism to allow yourself to not notice, for example, that this entire debate gets framed by white people calling non-white people “barbaric” without ever hearing a single one of the barbarians speak up for their side. You have Africans who speak against FGM, of course, but you don’t ever hear from Africans speaking for it. Why should you? They’re barbarians.

By contrast, there’s a moment in Bondo: A journey into Kono womanhood (Sunju Ahmadu‘s documentary) in which an anti-FGM activist asserts that African women think sexual intercourse is only for reproduction and a young circumcised Kono woman relies confidently that she can experience complete (and even greater sexual fulfilment) than her unexcised friend. Unless that voice is part of the debate, it’s not a debate. And as Ahmadu puts it,

Is it that African women are masochistic and disturb­ingly enjoy their own sexual subjugation? Or might this suggest that some Westerners and feminists have it wrong about the nature of African marriages, social systems and male-female interactions and intimacies? If the experi­ences of these Sudanese women are anything like my own and those of the community of women I was raised among, then I doubt very much that they are somehow sexually deviant masochists who are ignorant of and enjoy their own oppression.

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24 Comments to “The non-debate on FGC”

Great, great post, Aaron. This topic has made me uncomfortable for years: I have been repulsed by the liberal rhetoric against the practice (while instinctively not liking the sound of the practice itself), yet know nothing about why it exists, culturally. I was midway through your post ready to ask you about that, then you provide the fascinating excerpt from Fuambai Ahmadu. I intend to read more about it from those African sources. Thanks for suggesting them.

(My only caveat on the post is the focus on doctors needing to have “access” to communities, but that’s because I’m coming from a perspective that strongly resists the prevailing birth practices in this country, under the aegis of modern medicine. “How many mothers will die in childbirth because they didn’t get medical attention because they knew physicians would not allow them to do what they wanted with their children, for example?” Probably not as many as people fear.)

However getting the medical profession involved in this practice is not productive. All it will do is open doors to many kinds of law suits for starters. But additionally, and more important, the physicians are ignorant as hell as to what the practice is really about. ‘Nicking’ a infant girl in a doctor’s office will NOT provide what the practice of FGM is supposed to provide. It cannot. It is a community behavior.

In a productively functioning community — and emphasis cannot be too greatly put on community — performed responsibly — this ritual is far more than the tragic physical so-called surgery of a young female’s genitals.

This is like boot camp for female age cohorts, like the circumcision age cohorts for boys. The girls of a certain age group are sequestered. They are taught the women’s ‘secret’ rituals, songs and all sorts of other community social and ritual women’s information and practice. Going through all this terrible pain and healing knits this group of girls together, allowing them to act in cohort for women, for children, for the community. They know each other and they know everything about each other.

That is the most positive side of this.

Alas that so much is not, and is less and less so. The fathers and mothers who send their girls back to Africa to have this done are still depriving their daughters of the productive and positive aspects of the ritual, that bonding with friends, that knitting them into a community.

All that remains now, in so many places in Africa as well as in the U.S. is the cutting, what had been the physical proof of joining the community on the path to adult womanhood. Without the veiling of this ceremonial knitting into community and adulthood, the point of the cutting is clear: without this a girl can never get married.

There is no reason whatsoever that a girl living in the U.S. needs to be cut to get married. None. None. None.

And there are communities that practice such an extreme form that they will never be satisfied that nick fullfils the necessity.

And yes, there are communities that do perform this on babies and also on very little girls. Particularly communities that socially destablized, as so many as in Somalia are.

Another point that often gets conveniently ignored is that Americans have been performing clitoridectomies on infants at least since the 1950s — the reason is to make intersex infants look “normal”, though there has never been a legitimate medical justification for the procedure. (See _Fixing Sex_ by Katrina Karzakis.)

I’d love to see even *one* white American denouncing FGM while also acknowledging that white Americans perpetrate the same acts — and worse — under a veneer of medical professionalism.

While I must admit I get a little uneasy at any expression of complete dismissal (Foxessa’s “no reason…none. none. none.”) that’s more a fear of letting self-righteousness get in the way of the thought process. I have to admit I find it difficult to envision a scenario where, in the US right now, I wouldn’t be personally against the practice of FGC; as I said, insofar as my personal beliefs go, I’m against it. Where I lose patience with so many commentators on the issue, with whom I share a basic liberal aversion to the practice, is where they fail the knowledge test; the distinction Foxessa emphasized, for example, is incredibly important, that a practice like this can be good and make sense in the context of a viable community structure which imbues it with meaning but makes *no* sense in a place where that structure is not doing what it should. And one can only condemn a practice like FGC if you are cognizant of where it falls on that spectrum. The overwhelming majority of liberal commentators are just blithely oblivious to the entire issue.

Unfortunately, as both of you pointed out, the other unexamined assumption is that medical doctors can somehow step in and fill the gap, and that’s questionable too, just not in the terms these pundits address it. It’s useful to note the two strains of liberalism in play here, I think, each of which can be separately criticized in separate terms (which helps make it clear why you have this violent non-debate between doctors and pundits). The doctors see the problem as one of access, and of taking over a certain kind of authority from traditional practice. I suspect that, as Foxessa argues, they’ll probably fail (and Richard might be right that they might have an overweening sense of their own importance), but they at least understand the issue to be one in which respect, communication, and acknowledgment of difference are the only way to even get in the door. The commentators, on the other hand, are too interested in demonizing the practitioners (for whatever reason) to be able to see the larger picture, and I suspect that this is a different kind of tendency within liberalism, the us and them narrative of the secular liberal West and the irrational Muslim fanatics. Because even if the AAP’s multicultural tolerance is only a tactical concession, it represents something different than the name-calling polemicism one otherwise gets on the issue, a name-calling that demonstrates a basic obliviousness to all the important grey areas.

Tim,
That’s fascinating, and though my first (uninformed) reaction is to be wary of the easy parallel between the two, it certainly does demonstrate the bad faith of commentators who are up in arms about one type of infant abuse and utterly unconcerned with another, that when they try to justify their position by reference to universal principles they show themselves to be some combination of blinded by their own cultural position, hypocritical, or ignorant.

The example also makes me think that taking the entire question out of the realm of medical ethics is an important part of the rhetorical games these people are playing; it changes the context when you make it a political question, such that a comparison to things medical doctors do all the time comes to seem less and less relevant.

Oh, I think there are lots of reasons to be wary about the parallel. But I think there are also commonalities. From what little I’ve read, I understand that in some places where FGC is common, people believe that a woman with intact genitals just “doesn’t look right”. Surgery on baby girls with unusually large clitorises, on babies whose sex is indeterminate, and on baby boys with small penises (who are sometimes reassigned as female for that sole reason) has the exact same motivation (and not much more): what will the other girls think when they see her in the locker room?

I’m perfectly willing to acknowledge that the reason why no one draws a parallel between FGC and the mutilation of intersex infants is that they’re just not aware of the second. However, perhaps cynically, I suspect that if awareness increased, the scientific legitimacy that Americans attach to anything done by a medical professional would be a barrier to understanding the analogy. Somehow, it is weird for people in other cultures to do arbitrary things that an authority figure says are necessary, but not weird when people in American culture do those things, if that authority figure is a doctor.

And I think you’re right on the mark about taking the question out of the realm of medical ethics. The book by Karzakis (who is a bioethicist) explores pretty well (through interviews) how medical professionals who manage intersex infants and children make decisions based on a number of stunningly non-medical and non-scientific reasons that they have no special expertise in assessing. (Thea Hillman wrote that intersex activist Cheryl Chase, when she spoke at a medical conference for self-identified experts on intersex, was thanked sincerely for explaining that the clitoris plays an important role in women’s sexual functioning — this was news to them!)

In the 19th and earlier 20th centuries, clitorectomies were performed on adult women and adolescent women — and sometimes little girls too — because the doctors (male, of couse) claimed it would cure their ‘hysteria.’ Sometimes a horrified husband or parent brought the his wife or daughter to a doctor to have this done to cure her of masturbation. And so on and so forth.

This is the source of my Never Never Never.

We’ve already rolled back so much in the realm of women’s reproductive health in this nation. Abortion abolition is aimed at getting rid of contraception all together. All of this is aimed at getting women back where they belong — without legal right, recourse or identity.

Also, as with infant male circumcision — the doctors don’t do this at the birth of male babies out of concern for their health — they GET PAID for the procedure. They would sure as hell get paid here too.

D, I’ve given shots to many adolescents, and I have seen faiintng with a number of vaccines. Many teens actually know that vaccines make them faint, will tell me beforehand, and we have them lie securely on a table before administering anything. My understanding is that HPV vaccine is administered at age 9-11 because it’s an age where most girls are not sexually active. (Unfortunately, that is not always the case, but it’s a good bet). Once someone contracts HPV, the vaccine is less effective because it is not a novel virus to the immune system, and thus the immune system response is subpar.

I will think about this, more. And for a while. It is difficult for me to engage this topic as an analytical question because it triggers such a flood of emotions in me: I can see that this flooding is, in so many substantial ways, already there, and that the issue of FGC ‘taps’ into an ocean of….. of what? Of a whole gnarly host of interconnected, intertwined, entrapped, entangled, entrenched, embedded, and fraught experiencesmessagesscars (some of which are my own, some of which I have absorbed from the ether) about the sexuality of women. There are determinations and representations that I fight off because I sense they are so wrong, even when I can’t recognize or articulate to myself the full extent of why I believe they are damaging or harmful.

I do this without thinking.

I say this here because I think that part of what makes this debate or non-debate strained is this unspoken longing to protect women’s sexuality, and how this one practice bears, perhaps, a disproportionate weight as a site of action in that regard.

And I also say this because I believe that this can also be a powerful realm of neglect or disregard. I bet it’s safe to assume that this practice is not the same all over Africa, and if nothing else, you are constantly reminding us of the need to break that continental category down into is more lived and habitable contexts. I can say with a fair amount of confidence that this practice is definitely different in other places around the globe. Ahmadu’s description of this in Sierra Leone is a far cry from what I saw living in a village in Sumatra. Female circumcision (and that’s a direct translation from the vernacular, Minang) was performed on infants. Supposedly to remove the clitoral hood, but really, it often took more tissue than that. But there, and across other Muslim ethnic groups on different islands throughout the Indonesian archipelago, this practice seemed to mark one initiation into an understanding of female sexuality as something to be ‘controlled’: sexuality is to be experienced only within heterosexual (often arranged) marriage, and even there, the question of pleasure is subdued, if not suppressed. [just to be clear: I do not at all chalk this up to ‘Islam’, since there are loads of traditional sources which have been more liberally, generously interpreted than this particular group of Muslims, who claim this as an Islamic necessity…..] I heard a lot of stories of pain around that, of longing – for the satisfaction of pleasure, but also for a language of affirming its possibility. So there, too, female circumcision was (it seemed) something of a flash point in terms of bearing the symbolic weight of a woman’s life trajectory as a sexual, desiring being.

It is difficult to talk about this across racial and cultural asymmetries, you are right. But even within ‘one’ ‘culture’, I heard a lot of wistfulness, at best, and heated, desperate longing, at its most intense, to open up ways to think and practice differently in terms of supporting women’s sexuality. And those longings were often triggered or remembered or invoked around instances of girl baby circumcision…..

Just my thoughts about what I see as a larger ‘non-debate’ that subtends this one……..

While I think you’re right to point out the tone-deafness of FGM/FGC critics generally, it’s worth distinguishing between two very different questions that are in danger of being conflated here. If we–and, more importantly, the medical community–are opposed, however tentatively, to FGC/FGM, two questions emerge:

1) What do we do about FGC/FGM where it is practiced on people abroad, in communities we imperfectly understand?

2) What do we do about FGC/FGM where it is practiced on people in the U.S., in communities we imperfectly understand?

All the problems you mention obtain when we try to answer 1). But 2) presents a really different set of circumstances, and it’s that difference that makes the AAP recommendation seriously disturbing, as it advocates a policy that would have doctors actively performing a practice that has no medical benefit whatsoever as a hypothetical and (as both you and Foxessa point out) rather inadequate solution to an unsubstantiated problem. (The idea that “nicking” infants would satisfy the larger function of FGC seems to miss the cultural point of the practice altogether.) What’s more, according to the AAP recommendation, the condition that prompts us to ask question 2) can’t even be said to actually exist.

If we just told parents, ‘No, this is wrong,’ our concern is they may take their daughters back to their home countries, where the procedure may be more extensive cutting and may even be done without anesthesia, with unsterilized knives or even glass,” she said. “A just-say-no policy may end up alienating these families, who are going to then find an alternative that will do more harm than good.”

This is all speculative. There’s no data in the AAP report suggesting that any of this is happening. The sequence of events Dr. Friedman Ross outlines is unlikely (to say the least). How many girls are being sent back to their “native countries” (at considerable expense to their families) and then cut “with unsterilized knives or even glass”? Without actual numbers showing that this is a significant problem (and one the medical community has a hope of addressing), it makes no sense to advocate a policy that would make what’s currently costly, illegal and difficult—safeguards in their own right—easy, legal and cheap. Without demonstrating a clear need, the AAP is in effect proposing that it be possible for every female infant whose parents so choose to have her genitals cut when there is no medical benefit to doing so.

To suggest, as the AAP does, that doctors in the United States adopt this scattershot approach, where many women would be harmed and none (according the data) saved, is as nonsensical as it is pernicious.

There’s no question that it’s to everyone’s advantage for medical practitioners to become more conversant in the cultural practices of the communities they serve (Anne Fadiman does a great job exploring that in “The Spirit Catches You and You Fall Down”). And you’re right—the AAP report *is* informative and does make a good-faith effort to educate their members on the ways in which FGC is practiced across the world. But their proposal as to how it should be dealt with in practice in the US is as bizarre as it is likely to be ineffectual, and dangerous to boot.

All right, I’m sorry for jumping to conclusions there, but on one hand Arran said the practice is “fucked up repungant shit” but then he presents the other side quite confidently as if it’s the only side to care about. That’s where the cultural relativism claim came in for me. As I said before, reasons for FGC vary from country to country and I’m concerned it’ll be interpreted as using the Sierra Leone example to apply it to all the other countries.

You are quite correct that practices vary across borders and within countries – including Indonesia, Malaysia, and parts of Iraqi Kurdistan. This is not an exclusively African issue; although most of the countries are in Africa.

In the 19th century, it was very much an American issue (see a book called The Horrors of the Half-Known Life) because some misogynist American doctors prescribed clitirodectomies as a “cure” for female masturbation.

I am a member of an activist group here that works to educate everyone aroundt the world in all the issues — medical, emotional and cultural — that are part of the practices that clitorectomy and FGM are about. The platform position of the group is that this is a practice that needs to be, should be eradicated in all forms. It is mostly targeted to African women, because the board and those who founded this group are African women, some living here, some in Africa, some full time, some part time, some have been subjected to the practice and some not, or to a lesser form of it.

They’re right: the only way to effectively deal with a custom that is so many millennia established that no one knows where it comes from, is for the women to stop it. Men won’t, and they employ women as their surrogates to perpetuate it, as Chinese men employed their own wives and mothers to perpetuate footbinding on their daughters and sisters.

That this is about controlling the terror (to men) of women’s sexuality, and their power is certainly what FGM is about. However, then, over millennia, many other cultural traditions became attached to the practice too.

What, then, is it about Western culture that is detsetable enough to justify accepting the deviancy of foreign cultural values?IMO, a lot of it comes down to nothing more than racially sensitive political correctness; or better, a fear of being singled out for lacking it. No one wants to be called a racist or a xenophobe — very few people are intellectually nimble enough to handle it. And the ones that are also know that once you are tarred with those epithets, whether fairly or not, it is very hard to remove that modern-day scarlet letter. Which can be fatal to any leadership aspirations; oftentimes even public respectability.Which is why as a tactic such name-calling is so often used.

The AAP has a long way to go in forming a policy on genital cutting that displays even a modicum of gender equality and respects individual individuals’ right to autonomy. The leading Dutch medical organization recently made a move to stop male genital cutting; when will the AAP get it right?

you rant about baby girls etc
but could you accept that a somewhat more mature girl (early teens? or even a bit younger?) can support an idea of keeping the ritual and enuring some amount of pain? be it a prick with a needle, slight cut or even cutting away a minimal, symbolic, amout of skin (her choice!), scarring would be minimal enough and pain is a quite simple concept to understand. forcing something like that should be about as illegal as full-FGM (those who force will most probably go with full FGM anyway), but asking to volunteer is something else. or bribing to volunteer.
you really seem to forget that kids can make serious and informed choices too. for me, treating someone like a mindless pet instead of a real person is about as bad as takeing away some capability for sexual pleasure.

I’m a feminist with a master’s degree in anthropology and I am against FGM/C. Please note that when Dr. Ahmadu returned to Sierra Leone to be excised, she had a nurse inject her with antibiotics on site; a precaution not available to the other women at the initiation ceremony.
As a consenting adult, she chose the time and day for her excision; making her experience qualitatively different from that of millions of little girls who have no choice in the matter and who are excised or infibulated (by traditional practitioners who sometimes use the same cutting tool for a large group of girls) without anesthesia. In Egypt, over 90% of women are subjected to FGM. Why did the Egyptian government finally make it formally illegal? Because a 12 year old girl bled to death after being subjected to it. In the 1990s, a Gambian girl in France also died; leading to a much-publicized court case. There are other cases of death from FGM as well; sometimes from uncontrolled bleeding and sometimes from severe infections. I also recently saw an article in a psychiatric journal citing evidence that FGM can cause post-traumatic stress disorder and memory loss.

Dr. Ahmadu’s account ought to be considered in tandem with the narratives of childhood FGM survivors such as Waris Dirie and Ayaan Hirsi Ali; both of whom are ardently FGM and both of whom were infibulated as children without anasthesia.

The overwhelming consensus among NGOs and organizations as diverse as Amnesty International, CARE, Equality Now, Human Rights Watch, UNICEF, and the World Health Organization is that FGM is a human rights violation. It stretches credulity to claim that all of them are somehow engaged in a vast imperialist conspiracy to defame African women when there are African women working in support of their efforts to end FGM.

Due to the courage of women like Faussiya Kassinja, there is now a fairly well established legal precedent in the United States that the risk of being involuntarily exposed to FGM is a well-founded fear of persecution and grounds for granting legal asylum in the United States.

As many courageous African doctors and health workers know, (who are against FGM NOT because someone white and Western told them to be against it because they saw the pain that it causes and the harm that it does with their own eyes), there are culturally sensitive strategies for encouraging abandonment of these practices. TOSTAN (www.tostan.org) is an indigenous women’s organization that has a great track record in doing this.

Dr. Shweder will sometimes cite medical literature by Morison et. al. and Catania et. al. to promote his argument that the health damages of FGM are exaggerated. (I had an e-mail exchange with him and he sent me the articles.) However, each of the two articles explicitly notes that FGM is a human rights violation. I could not agree more.

Meant to say that Waris Dirie and Ayaan Hirsi Ali are both ardently anti-FGM in the previous post. In addition, for someone who is calling for greater respect for African women, I find it ironic that Dr. Ahmadou is dismissive of African FGM survivors who use the term “female genital mutilation” to describe what happened to them; one of them pointing out to Dr. Ahmadou that she did NOT need a Western woman to tell her that what had happened to her was painful and harmful and that she therefore did not want it to happen to other girls and women.

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